Los Angeles County, California
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Sexy…Healthy…Empowered!
A sexual health discussion group for college women.
2007 Adaptable Curriculum
Developed by:
Los Angeles County Department of Public Health
Sexually Transmitted Disease Program
Health Education Unit
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Table of Contents
I. SHE Program Overview
II. Goals and Objectives
III. Session 1 Outline, Scenarios and Handout
IV. Session 2 Outline, Scenarios and Handout
V. Recommended Readings for Sessions 1 and 2
VI. Post-Tests and Evaluations for Sessions 1 and 2
VII. Appendix
a. SHE Sample Sign-In Sheet
b. Sample Assessment for Staff
c. Sample Assessment for Students
d. Suggested Risk Reduction Supplies for Safer Sex Kits
e. Brochure Resources
f. Literature Review Summary
SHE Program Overview
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Program Overview
SHE is designed to facilitate a discussion about sexual health issues among college women in order to increase their knowledge and practice of safer sex. SHE creates a non-threatening, non-judgmental atmosphere in which participants can learn, engage in interactive activities, evaluate hypothetical scenarios and contribute to the discussion to ultimately become more sexually healthy. Participants need not be currently sexually active to benefit from SHE.
SHE is facilitated by female Health Educators and is divided into two 2-hour sessions, approximately one week apart. In order to facilitate discussion and participation, SHE will be limited to a maximum of 15 participants.
SESSION 1:
The first session will focus on identifying and discussing the various issues that can affect one’s sexual decision-making. These include values, beliefs and attitudes about a variety of sexual health topics such as dating/relationships, body image and self-esteem.
The session will begin with a general icebreaker/introduction activity. Facilitators will lead the group in a brainstorm/discussion about the different factors involved in sexual decision-making. Participants will then have an opportunity to evaluate hypothetical scenarios and discuss the consequences of certain decisions. A list of recommended readings, pertinent resources including our STD Hotline, and information on the school’s medical and psychological services will be given to participants at the conclusion of the session.
SESSION 2:
The second session focuses on STDs and making safer decisions about sex. The session will open with re-introductions/icebreaker activity followed by a general discussion of STDs and what specifically puts women at risk, underscoring the fact that women are more susceptible to STDs due to their reproductive make-up. Regular testing and other risk reduction measures will be emphasized. A skills-building exercise will follow and focus on the contents of the safer sex kit. Each participant will have the opportunity to not only learn how to reduce their risks but also practice using male and female condoms, lubricant, and other safer sex items. Birth control options will be discussed in the context of STD transmission protection. Finally, the session will close with tips and an activity on negotiating safer sex with partners, as well as the distribution of recommended readings and other important resources.
For more information about SHE, please contact NAME at PHONE or EMAIL ADDRESS.
Goals and Objectives
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Goals and Objectives
Goal: To encourage discussion of sexual health issues among college women, in order to increase their knowledge and practice of safer sex.
Objectives - Session 1
By the end of Session 1, group participants will be able to:
✓ Define values and attitudes
✓ Define of self-esteem
✓ Define body image
✓ Explain the effect self esteem, body image, and values/attitudes can have on sexual decision-making
✓ List 3 possible consequences of having sex
✓ Identify 2 ways to improve self-esteem
Objectives - Session 2
By the end of Session 2, group participants will be able to:
✓ Explain and demonstrate the proper way to use a…
o Male condom
o Female condom
o Lubricant
✓ Explain the difference between oil- and water-based lubricants
✓ Identify which methods of birth control protect a woman from STDs
✓ Identify one method of negotiating safer sex with a partner
✓ Identify 2 resources for obtaining information on STDs
Session 1 Outline
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
SESSION 1 – What Influences Sexual Decision-Making?
2 Hours
Session 1 Workshop Objectives
At the end of the workshop, participants will be able to:
✓ Define values and attitudes
✓ Define of self-esteem
✓ Define body image
✓ Explain the effect self esteem, body image, and values/attitudes can have on sexual decision-making
✓ List 3 possible consequences of having sex
✓ Identify 2 ways to improve self-esteem
Materials Needed
✓ Butcher paper
✓ Color markers
✓ Name tags
✓ Sign-in sheet
✓ 2 pens for sign-in sheet
✓ Pre-written ground rules on butcher paper (post on wall)
✓ Incentive items (e.g., pens, highlighters)
✓ Subject-appropriate brochures: self-esteem, body image
✓ Handout – Simple list of ideas for improving self-care
✓ Blank sheets of paper (for Compliment Game, if time allows)
✓ Handout - Post test/Evaluation (double-sided copy)
✓ Handout - Scenarios I (3 copies of each scenario)
✓ Handout - Recommended Reading for Session 1
✓ Local and other resources (e.g., school health/counseling services, local clinics, Los Angeles County STD Hotline)
✓ Food, if applicable
I. Introduction and Ground Rules – 15 minutes
Introductions
2 Go around the room and have each participant introduce herself by stating her name, year in school/major, and answer the question, “name one concern you have about sexual experiences in your peer group” (alternate: “what brought you to SHE today?”)
o Trainers should also introduce themselves
o Make sure to thank everyone for taking time out of their busy schedule to attend this discussion group.
What is SHE?
o SHE (Sexy, Health and Empowered) was designed to facilitate discussion about sexual health issues among college women in order to increase their knowledge and practice of safer sex.
o SHE’s aim is to foster a non-threatening, non-judgmental atmosphere within a small group setting, in which women can informally talk about the various issues that play a significant role in safer sexual decision making (i.e., body image, self esteem, values), learn about STDs, practice using safer sex items, and negotiate safer sex with partners
o Participants can benefit from SHE whether or not they are currently sexually active
o SHE is a two-part workshop, about 2 hours each session
o Second session is scheduled to take place location, time (note: Session 2 should ideally take place one week later, 2 weeks apart at most)
Ground Rules - Pre-write on butcher paper (bold statements below) and post on wall
Don’t be afraid to share your thoughts or ideas for fear of saying something “wrong”. Some of our best learning comes from mistakes, so everyone will be supported for taking risks and making mistakes.
We acknowledge the individual differences among members of this group. We will not agree on everything and that is ok.
Make “I” statements
You have the right to pass on any activity
Confidentiality guidelines will be adhered to by all
Please silence all electronic devices (mobile phones, pagers, etc) by turning them on vibrate or turning them off.
II. Discussion – Factors that Influence Sexual Decision-Making - 45 minutes
• To begin the discussion, ask participants to think about the different factors that can influence sexual decision-making. What kinds of things influence a woman to have or not have sex?
o One facilitator facilitates while the other writes their responses on a sheet of butcher paper
• Explore their responses…ask participants how each factor influences sexual decision-making.
o Tip: You may want to ask them to rank the top three factors if they are coming up with a long list of ideas and time is an issue
• If not already stated as a factor, tie in/lead into a discussion on the following factors that play a significant role in sexual decision-making: Self-Esteem, Body Image, and Values/Beliefs/Attitudes about sex.
1. What is Self Esteem?
o Ask the group to define it
o As they call out words or definitions, write them on another piece of butcher paper
o Provide or clarify the definition of self-esteem: Self-esteem is essentially pride in oneself; self-respect
o Most people’s feelings and thoughts about themselves fluctuate somewhat based on their daily experiences (i.e. accomplishments, getting asked out on a date, etc), which can have a temporary impact on your wellness.
o Your self-esteem, however, is something more than normal “ups and downs” associated with situational changes.
o For people with good basic self-esteem, normal “ups and downs” may lead to temporary fluctuations in how they feel about themselves, but only to a limited extent. In contrast, people with poor basic self-esteem, these “ups and downs” may make all the difference in the world.
Low Self Esteem vs. High Self Esteem
o Ask participants what they think are characteristics of high vs. low self esteem
▪ High – e.g., high self worth, optimistic outlook on life, pride in one’s accomplishments, good social support, strong sense of individuality
▪ Low – e.g., little to no self worth, don’t feel deserving of support/love, little to no self-confidence
o How would this contribute to sexual decision-making?
▪ May rely on other people to validate their own self-worth (e.g., through sex). Protecting one’s health and well-being may be a low priority (or not even a priority) for that person. This may put her at higher risk for STDs, an unplanned pregnancy, intimate partner violence, etc.
2. Values/Beliefs and Attitudes about sex and relationships
o Ask participants what they think are value/beliefs and attitudes? Where do they come from (e.g, family, life experiences)?
o Write responses on butcher paper
o Provide or clarify definitions: Values are principles that guide our behavior, while attitudes express our values
o Why are they important? How can they influence sexual decision making?
o Values essentially make up who we are, however they can change over time. It is important to assess where we stand on values related to sex and relationships so we can make the decisions that are right for us.
3. Body image
o Ask participants what they think body image is
o Write responses on butcher paper
o Provide or clarify definition: Body image is defined as the way a person thinks about her body and how it looks to others
o What influences body image? What is the difference between healthy vs. unhealthy body image?
o Write responses on butcher paper
o Highlight media influence and stereotyping
o Make the point that someone does not have to fit society’s image of the “perfect body” to have good/healthy body image.
o How can an unhealthy body image influence sexual decisions?
▪ Similar to self-esteem, having a poor view of your body may lead to increased risk of putting yourself in a vulnerable place in a sexual relationship, and possibly at risk for STDs, etc.
III. Activity – Scenarios - 30 minutes
o Now that we’ve discussed the different factors that can influence decisions about having sex, and we’ve talked about self-esteem, values/beliefs/ attitudes, and body image, let’s delve further into these issues by assessing some scenarios.
Follow the instructions on the Scenarios 1 sheets
IV. (Optional, only if time allows) Activity: The Compliment Game - 10 minutes
o Make sure that each participant’s nametag is visibly placed on her chest. All names must be legible on the tag.
o Instructions: Put your name on a piece of paper. Pass the paper on to the person to the right of you. The person who receives the paper is to write something nice about the person whose sheet she has received. If you do not know who the person is, use her nametag to identify her and write nice about her. All comments must be positive and/or complimentary. The sheet is to circulate to everyone in the room until it returns to the person whom it belongs to.
V. Debrief – 5 minutes
Resources for improving self-esteem
o “Check Out” with participants: “How are you feeling right now?” or “One thing I will take away from this session is…”
o Self-help reading materials (Distribute Recommended Reading handout - Session 1)
o Stress the importance of self-nurturing – pampering one’s self can increase self esteem, healthy body image (Distribute Handout)
o Seek counseling, if needed
o Face-to-face – talking to a professional about one’s issues can help many people identify troubling issues. Counseling services are available at no additional cost to students at most colleges/universities.
▪ Write or distribute information on school’s psychological services, as well as other pertinent local resources
o Hotlines – if you are uncomfortable discussing these things directly, anonymous hotlines can put you in touch with a trained individual who will help you and not judge you
▪ STD Hotline 800-758-8000
▪ Other hotlines relevant to topic and area
o Q & A
VI. Wrap-Up – 5 minutes
o Distribute and have participants complete post-test and evaluation
o Briefly preview the second session – date, time, location, safer-sex kits, lots of goodies, etc.
o Thank participants once again for taking time out of their busy schedules to attend.
Session 1 Scenarios
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Scenarios for Session 1
Instructions
The following are three scenarios with three different options/outcomes. Divide the class into three groups (3-5 women each group max). Each group will be pre-assigned one of the three options for each scenario. Allot approximately 30 minutes for this exercise. Depending on time constraints, there may only be enough time to go over 2 scenarios. If that is the case, pick between scenarios #1 or #2 along with scenario #3.
Once the participants are in their respective groups, distribute a piece of butcher paper and a marker to each group. Tell each group to divide one of their sheets into three categories: Values/Attitudes/Beliefs, Self-Esteem, Consequences. It is ok to ask for more paper if needed.
Distribute the first scenario. Assign each option/outcome to a group. Instruct them to:
• Assume the role of the character for each scenario
• Brainstorm the contributing factors for the decision made (values/attitudes/beliefs, self-esteem, consequences) and write them down
• Brainstorm the possible consequences of the character’s decision (consider STDs, birth control, pregnancy, etc) and write them down
Read the scenario together as a group, and then give the groups about 10 minutes to write their comments. Remind everyone that there are no right or wrong answers. Also, we are not passing judgment on these characters, but rather assessing what could be going on with her. When completed, have each group post their paper on the wall and pick one member of their group to be their “spokesperson”. Each group will then take turns reporting their findings.
Repeat for second scenario.
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Scenario #1
Character: Raquel is an 18 year-old college freshman living in the dorms...
During chemistry class, Raquel meets a really cute guy named Mike. After a few casual conversations, Mike asks Raquel out on a date for the following weekend. Not only is this guy gorgeous, but this is also her first date away from home...no parents, no curfews, AND her roommate will be out of town that weekend.
Mike and Raquel go out to a movie and have a great time. After the movie Mike takes Raquel back to her dorm room, and since her roommate is gone they decide to hang out for a while and have a few beers. One thing leads to another and they start making out. It’s obvious that Mike wants to have sex. Raquel is very attracted to Mike and they’re both feeling a little buzzed.
What does Raquel do?
Group I: She goes for it because everything is “perfect” for a one-night fling. Plus, it’s fun having sex while buzzed.
Group II: Raquel goes for it because she wants to show Mike that she is really interested in him and would love to be his girlfriend.
Group III: She backs off because she’s had a little too much to drink and doesn’t want to regret it in the morning.
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Scenario #2
Character: Erika is a 19 year-old college sophomore…
Erika’s roommate invites her to a fraternity party off-campus. She’s excited because she believes that a lot of cute guys belong to this fraternity. At the party, she spots a number of guys and keeps her eye on one guy in particular, Steve. Throughout the evening, she keeps looking over at him. Even though he notices her interest in him, he’s a bit pre-occupied with partying. Towards the end of the night, a tipsy Steve walks over to a sober Erika and starts talking to her. She’s excited that he’s talking to her. During the conversation, Steve leans over and kisses Erika. Steve then takes Erika’s hand and leads her outside. She willingly goes. They resume kissing and end up having a very heavy make-out session. Steve makes it very apparent that he would like to have sex with Erika.
What does Erika do?
Group I: She backs off because she believes the situation has progressed a lot further than she wanted it to.
Group II: She goes for it because she finds this very exciting and is totally turned on. She can’t believe she is making out with such a cute fraternity guy!
Group III: She goes for it because she thinks she’s gotten herself into a situation she can’t get herself out of.
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Scenario #3
Character: Jeanette is a 22 year-old college senior…
Jeanette has been dating Kara for the past six months. Things have been going great, in fact Kara just asked Jeanette to move in with her. Jeanette loves Kara, but is scared about making such a big commitment so quickly. One weekend while Kara is out of town, Jeanette’s good friend Matt invites her over to his place to kick back and have a few drinks. While talking about Jeanette’s dilemma, Jeanette and Matt have several shots of tequila and smoke some pot. Matt tells Jeanette she should cool things down with Kara, and confides that he has had a crush on Jeanette ever since he met her. A buzzed Jeanette is feeling attracted to Matt, but is not sure whether it’s because she’s afraid of committing to Kara or whether she really does like Matt after all these years. Matt kisses her and they start making out.
What does Jeanette do?
Group I: She backs off because she has had way too much to drink and smoke. More importantly, she doesn’t want to cheat on Kara and ruin her friendship with Matt.
Group II: She goes for it because she doesn’t want to hurt Matt’s feelings.
Group III: She goes for it because Kara is out of town and Matt is looking pretty good right now.
Session 1 Handout
Gifting/Nurturing Yourself for Little or No Money
Read a book Take vitamins
Rent a video or DVD Do mini-workouts
Meet or call a friend Write a story
Write in a journal Give yourself a facial
Write a poem Give yourself a manicure/pedicure
See a movie Speak the truth
Dance to music on the radio Support one thing that’s important
Soak in a tub Sit in a Jacuzzi
Light candles Daydream
Fix lunch/dinner for a friend Cuddle
Plan and prepare healthy meals Grow
Exercise Stretch
Take a walk Look for the gift in setbacks
Spend time with your pets Have one glass of wine
Meditate Value the gift you get
Watch a sunset Take a day trip
Drink 8-10 glasses of water per day Practice spirituality
Work on a hobby Take a local weekend trip
Turn off the phone Eat by candlelight once a week
Sing If the ball comes your way, catch it
Limit interactions with toxic people Schedule time to relax
Go to a museum, exhibit or art show Go to bed earlier
Take deep breaths If you lose, practice harder
Rest Buy yourself fresh flowers
If it’s collecting dust, throw it out When you win, be a good sport
Dress up Send kids with family/friend for a day
Forgive yourself Find the pearls in your irriations
Write positive things about yourself Watch something special on TV
Scratch the itch Go to a used bookstore
Be a friend to yourself Put stickers in calendars as rewards
Go sightseeing in the neighborhood Drive your own life
Kiss a baby Go to the beach
Take a day off Listen to nature
Smile Say daily affirmations
Have breakfast in bed Sleep late on a day off
Go to the mall/window shop Listen to music
Garden Plant some seeds
Forgive someone Be the captain of your own soul
Drive up/down the coast Send a card to a friend
Laugh Walk a dog
Ride a bike Realize you cannot take care of
Live better today everyone else’s problems
Pack a healthy lunch Mind your own business
Make your living area peaceful Don’t create drama
Gifting/Nurturing Yourself for Little or No Money
Eat with your brain Design special cards for special people
Eat creatively Do the dance of life
Organize: file don’t pile Throw out the word “should”
Recycle fronts of cards Watch how you feel around people
Use stationery from hotels Don’t let people “hammer” on you
Love with an open hand Love your inner child
Adopt a huggie toy Live in the moment
Watch a sad movie, have a good cry Reflect on your own strengths/growth
Be part of the solutions Snuggle with someone
Give yourself permission to feel Blush
Have a “crush” on someone Forgive yourself
Step out of denial Value your freedom
Eat in a peaceful environment Give thanks
Tell somebody how you feel Connect with other human beings
Take a risk Accept your own process
“Fire” the judges in your head Keep at your own personal pace
Pat yourself on the back Laugh at your mistakes
Stroke your cheek Encourage
Love humanity Count your blessings
Hold hands in the circle of life Allow yourself to feel sexy
Share your growth secrets with others Be true to yourself
Examine your pride Be okay with saying “no”
Recognize we are part of each other Make yourself feel safe
Give it away to keep it Be sincere
Wear comfortable shoes Care
Walk away Trust your gut feelings
Never get too angry Don’t settle for less
Expect honesty Never get too tired
Give from your heart Keep a treasured secret only you know
Believe you are unique Live and let live
Avoid negativity Wear your favorite shirt
Skip Contribute
Give up power and control Say good-bye
Schedule one day/month for yourself Walk in dignity
Draw Listen to the quiet
Keep picture of a loved one close Smile
Let go of an attachment Publicize your accomplishments
Dance Create bliss
Session 2 Outline
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
SESSION 2 – Making Sex Safer
2 Hours
Session II Workshop Objectives
At the end of the workshop, participants will be able to:
✓ Explain and demonstrate the proper way to use a…
o Male condom
o Female condom
o Lubricant
✓ Explain the difference between oil- and water-based lubricants
✓ Identify which methods of birth control protect a woman from STDs
✓ Identify one method of negotiating safer sex with a partner
✓ Identify 2 resources for obtaining information on STDs
Materials Needed
✓ Butcher paper
✓ Color markers
✓ Name tags
✓ Sign-in sheet
✓ 2 Pens for sign-in sheet
✓ Ground rules butcher paper from Session 1
✓ 4 demo safer sex kits (3 for participants plus 1 for facilitators)
o See “Suggested Risk Reduction Supplies for SHE Safer Sex Kits” Word document
✓ Female pelvic model for female condom demonstration (optional)
✓ Mix of lubed, flavored, and colored male condoms; female condoms; and lubricant for distribution plus bags or boxes to store in (or pre-assemble in goody bags)
✓ Subject-appropriate brochures: STDs, birth control options, emergency contraception, how to use a condom, drinking/substance use and sex, sex and communication
✓ STD pictures
✓ Incentive items
✓ Handout - Post test/Evaluation (double-sided copy)
✓ Handout - “Where are you in terms of readiness to negotiate safer sex with partners”
✓ Handout - Recommended Reading for Session 2
✓ Local and other resources (e.g., school health services, local clinics, Los Angeles County STD Hotline)
✓ Food, if applicable
I. Introductions – 15 minutes
o Sign-in sheet
o Briefly revisit ground rules, re-set non-judgmental, non-threatening tone
o Re-Introductions
▪ Along with introducing themselves, ask each participant to briefly tell the group about how and when they first got the “sex talk”
II. STDs/Safer Sex Kits/Negotiating with Partners - 60 minutes
STD 101
• If you plan to have sex or are currently having sex, you need to think about STD’s and HIV and ways you can reduce your risk of getting them
• There are over 25 different STD’s that exist, but we commonly hear about 8-10 of them (for example, Chlamydia, Gonorrhea, Herpes, HPV/Genital Warts, etc)
• Unfortunately we don’t have enough time to go over them in detail but will provide you with a quick overview before discussing the various ways to reduce your risk.
o For more information refer to STD brochures
• Transmission
o You can get an STD by coming in contact with infected vaginal fluids/secretions, semen (including pre-cum) and blood. You can also get infected through skin-to-skin contact.
o The activities that can put you in contact with these are vaginal sex, anal sex, oral sex and foreplay (rubbing)
• Symptoms (distribute or refer to STD color photos in kit)
o Can include blisters, bumps, pain in the genital area, burning with urination, unusual discharge from the vagina (explain normal vs. abnormal, and how it can vary from woman to woman), anal discharge
o What do you think is the most common symptom?
▪ NOTHING at all!
▪ Females more than males tend to be asymptomatic because of our biology
• Vaginal environment (mucous membrane vs. skin, warm/moist environment, internal (females) vs. external (males), cervix has very few nerve endings
• Ectopy – vulnerable immature cervix of females under 25 years of age
• Complications
▪ PID – infertility, chronic pelvic pain
▪ Cervical cancer
▪ Others, including death
• Testing
o What it means and doesn’t mean
▪ Common misconception about paps
▪ Ask specifically for tests
▪ May not be able to get tested for some STDs
• Note difficulty in getting tested for Herpes and HPV
• Treatment
o Some STDs are curable with the right medicine. Other STDs are not curable but can be treated or managed with the right medicine.
*Important to Note: Even sexually responsible (i.e., using condoms, getting tested regularly, etc) people can still get infected with an STD (e.g., skin-to-skin STDs). Risks are a part of every aspect of our life. However, taking as many measures as you can to protect yourself will help reduce your risk of contracting an STD.
Safer Sex Kits
• Divide the class into 3 groups of 3-5 participants
• Provide each group with a safer sex kit
• Quickly go through each of the items
• Ask a group to demonstrate…
o Correct use of male condom using a dildo, banana or fingers
▪ Note that there are flavored, un-lubed male condoms for oral sex
o Correct use of the female condom using the pelvic model or hands
o Correct use of lubricant
▪ Oil vs. water-based and why important
o Remember to emphasize why lubricant is important overall…can help reduce transmission of skin-to-skin STDs by reducing friction and irritation (e.g., micro-cuts from dry sex)
o Groups can use instructions provided if they’re not sure how to use
• Latex barriers demonstration (facilitators, if time permits)
o Dental dams (can purchase in some pharmacies or specialty sex shops; can make one out of male condom (demo) or can use saran wrap
o Using latex gloves
▪ Finger cots
▪ Option for oral sex example
• Cut three middle fingers, as well as down the center of the glove from the middle finger down. This creates a latex barrier for oral/vaginal or oral/anal sex that has thumb holders (easier to identify which side is yours)
• Birth control vs. STD protection
o For example, the pill will prevent pregnancy but not protect against STDs
o Refer participants to birth control brochures for more information
• Making own kits – Place jars of lubed condoms, flavored condoms, and lubricants out on table. If they’d like, participants can choose 5 of each for their kits. Bring bags or little boxes for kits.
o Keeping your own safer sex kit at home and on the go – use decorative boxes/caboodles/storage compacts, etc. Store in a cool, easily accessible place.
o Alternative to having participants make own kits (particularly if short on time): Facilitators can pre-assemble goody bags.
Making responsible sexual decisions
• Personally assess your values and what you want out of a relationship. As homework, determine where you are in your readiness to negotiate with partners (distribute handout).
o Key is having or not having sex on your own terms
o Revisit how low self-esteem or body image might hamper assertion
• Effects of substance use and drinking on sex
o Can lead to poor sexual decision-making or cause you to forget about negotiating
o May make it easier for sexual assault or acquaintance/date rape to occur
o Refer to brochures
Negotiating with partners
o This is about respect for yourself and your body, as well as respect for your partner and his/her body
o This is not an easy thing to do. Most of us were never taught how to do this. It’s okay to feel nervous.
3 Suggestions for talking to partners
• Try to talk about safer sex, getting tested, STD status (if applicable), and contraception BEFORE you get sexual, whenever possible.
• However, if you didn’t or don’t want to talk about this with your partner, then always be prepared to reduce your risks…use condoms, lubricants, etc., and get tested regularly.
• Suggestions to keep in mind:
• Find a secure, private place to talk with minimal interruptions
• Easier to do sooner rather than later
o When will you see your partner next? Is this a good time?
o Ideally discuss before you get intimate (may not be so effective if brought up in the heat of passion)
• Think of the words you will use and practice saying those words
o Practice in front of a mirror or with a trusted friend
• Anticipate partner’s reaction
o What questions might they have? How might you respond?
o Is it safe to talk to your partner? If you feel threatened in any way, do not discuss! (domestic violence or intimate partner violence resources)
• Have resources on hand
o Clinics to get tested, hotline numbers
III. Activity – Scenarios - 20 minutes
• Follow the instructions on the Scenarios 2 sheets
IV. Debrief – 5 minutes
• Offer resources for sexual health – distribute Recommended Reading for Session 2
o Note: A lot of books are great as novelties, such as books of sexual positions, but not nearly enough of them address real issues pertaining to health, self-issues and getting to know one’s own sexuality
• Health care providers: school health services, other local clinics
o STD Hotline 1-800-758-0880
o Distribute information on emergency contraception hotlines
o Offer domestic/intimate partner violence resources or hotlines
o “Check Out” with participants: “How are you feeling right now?” or “One thing I will take away from SHE is…”
VI. Wrap-Up – 5 minutes
• Distribute post-test/evaluation
• Thank everyone for their participation and for attending.
Session 2 Scenarios
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Scenarios for Session 2
Instructions – How to Talk to Partners
As a group, pick Scenario #1 (talking to partner about using condoms – heterosexual couple) below and read it aloud. Then ask the group to brainstorm and come up with different ways the character in the scenario can bring up the topic of safer sex.
• Optional: writing ideas on butcher paper
• Optional: providing copies of scenarios to each participant
If time permits, repeat with Scenario #2 (talking to partner about getting tested – WSW), Scenario #3 (talking to partner about STD diagnosis – heterosexual couple).
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Scenario #1
Character: Jessica is an 18-year-old college freshman...
Jessica is in a new relationship with Nick, and she’s decided that she’s ready to have sex. She’s concerned about STDs and pregnancy. How does Jessica bring up the matter of using condoms with her boyfriend, Nick?
What does Jessica say to Nick?
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Scenario #2
Character: Katrina is a 22-year-old college senior…
Katrina decides it’s time for her and her partner Emily to get tested for STDs. How does she bring this up with Emily?
What does Katrina say?
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Scenario #3
Character: Ann is a 20-year-old college junior …
Ann went to her gynecologist for her annual Pap Smear and STD exam two weeks ago. Her doctor just called to tell her she has an STD. Luckily the STD is curable, but of course Ann is upset. She has to tell her boyfriend Andy so he can get tested too.
What does Ann say?
Session 2 Handout
Where are you in terms of readiness to negotiate safer sex with partner(s)?
Whether you plan to have sex in the future or you’re currently having sex, it’s a good idea to think about your readiness to talk to your partners about using safer sex methods (i.e., using condoms, lubricants, getting tested, etc) to reduce the risk of STDs/HIV and pregnancy.
Take a few minutes and identify where you are on the spectrum of readiness:
Pre-Contemplation Stage: You haven’t even thought about talking to partner(s). Perhaps you haven’t thought about it because you didn’t know about it, or because you think it’s not an issue for you right now.
Contemplation Stage: You’ve thought a little bit about the idea of talking to partner(s.) However, you may not know or thought about how to actually do it.
Preparation Stage: You have thought about it and are thinking of ways to talk to partnter(s). You may have practiced the words you are going to use, thought about the best time to broach the subject, etc. so when the situation presents itself, you will be prepared.
Action Stage: You take the step to talk to your partner(s).
Maintenance Stage: You regularly talk to you partner(s) about using safer sex methods.
Once you have identified where you are at on this spectrum of readiness, answer the following questions:
1. If you’re in the Pre-Contemplation or Contemplation Stages, what do you think you can do to move yourself into the Preparation Stage? What barriers may prevent you from moving into this stage? What small steps can you take to overcome these barriers?
2. If you’re in the Preparation Stage, what can you do to move yourself into the Action Stage? What barriers may prevent you from moving into this stage? What small steps can you take to overcome these barriers?
3. If you’re in the Action Stage, what can you do to move into the Maintenance Stage? What barriers may prevent you from moving into this stage? What small steps can you take to overcome these barriers?
4. If you’re in the Maintenance Stage, what can you do to ensure that you remain in this stage and not “relapse”? What things might cause you to relapse? What small steps can you take to help prevent a relapse?
Recommended Readings for Sessions 1 and 2
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Recommended Reading
Session 1
▪ Our Bodies Ourselves for the New Century
▪ The Beauty Myth by Naomi Wolf
▪ Body Outlaws: Rewriting the Rules of Beauty and Body Image by Ophira Edut
▪ Body Image: A Reality Check
▪ The Body Project
▪ The Self-Esteem Workbook by Glenn Schiraldi
▪ The Body Image Workbook by Thomas Cash
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Recommended Reading
Session 2
▪ The Hot Guide to Safer Sex by Yvonne Fulbright
▪ Safely Sexual by Robert Hatcher
▪ Sexual Health: Questions You Have … Answers You Need by Michael Reitano
Post-Tests and Evaluations for
Sessions 1 and 2
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Session 1 Post-Test
XYZ College, DATE
After attending SHE Session #1:
1. I understand the definition of self esteem…
□ Less
□ More
□ About the same as before this SHE session
2. I understand the definition of values/attitudes…
□ Less
□ More
□ About the same as before this SHE session
3. I understand the definition of body image…
□ Less
□ More
□ About the same as before this SHE session
4. I understand the effect self esteem, values, and body image can have on sexual decision-making…
□ Less
□ More
□ About the same as before this SHE session
5. List 3 possible consequences of having sex
____________________________________________________
____________________________________________________
____________________________________________________
6. List 2 ways a woman can improve her self-esteem
____________________________________________________
____________________________________________________
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Session 1 Evaluation
XYZ College, DATE
1. How closely did this SHE session meet your expectations?
? Fully met ? Somewhat met ? Not met at all
2. How was the length of this session?
? About right ? Too long ? Too short
3. How would you rate this session overall?
? Excellent ? Good ? Fair ? Poor
On a scale from 1 to 5, please rate the following sections of the training session:
Defining Body Image, Values/Attitudes, Self-Esteem
Not clear Clear Very clear
1 2 3 4 5
Not effective Effective Very effective
1 2 3 4 5
Scenarios Exercise
Not clear Clear Very clear
1 2 3 4 5
Not effective Effective Very effective
1 2 3 4 5
6. What did you like the best?
7. What did you like the least?
8. Any other comments for how we can improve SHE session #1?
( THANK YOU (
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Session 2 Post-Test
XYZ College, DATE
After attending SHE Session #2:
7. I am ____ confident I can correctly use a male condom
□ Less
□ More
□ About the same as before this SHE session
8. I am ____ confident I can correctly use a female condom
□ Less
□ More
□ About the same as before this SHE session
9. I am ____ confident I can correctly use latex barriers
□ Less
□ More
□ About the same as before this SHE session
10. I understand the difference between oil- and water-based lubricants…
□ Less
□ More
□ About the same as before this SHE session
11. I feel _____ confident in my ability to negotiate safer sex with a partner
□ Less
□ More
□ About the same as before this SHE session
12. Which method(s) of birth control also protect against STDs?
____________________________________________________
13. Identify 2 resources for obtaining information on STDs…
____________________________________________________
____________________________________________________
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Session 2 Evaluation
XYZ College, DATE
3. How closely did this SHE session meet your expectations?
? Fully met ? Somewhat met ? Not met at all
4. How was the length of this session?
? About right ? Too long ? Too short
3. How would you rate this session overall?
? Excellent ? Good ? Fair ? Poor
On a scale from 1 to 5, please rate the following sections of the training session:
STD Overview/Safer Sex Kits
Not clear Clear Very clear
1 2 3 4 5
Not effective Effective Very effective
1 2 3 4 5
Making responsible decisions (negotiating safer sex)
Not clear Clear Very clear
1 2 3 4 5
Not effective Effective Very effective
1 2 3 4 5
9. What did you like the best?
10. What did you like the least?
11. Any other comments for how we can improve SHE session #2?
( THANK YOU (
Appendix
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Sign-In Sheet
XYZ College
Session 1
Date:
Time:
|Name |Year |Dorm (if applicable) |
|1. | | |
|2. | | |
|3. | | |
|4. | | |
|5. | | |
|6. | | |
|7. | | |
|8. | | |
|9. | | |
|10. | | |
|11. | | |
|12. | | |
|13. | | |
|14. | | |
|15. | | |
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
Sign-In Sheet
XYZ College
Session 2
Date:
Time:
|Name |Year |Dorm (if applicable) |
|1. | | |
|2. | | |
|3. | | |
|4. | | |
|5. | | |
|6. | | |
|7. | | |
|8. | | |
|9. | | |
|10. | | |
|11. | | |
|12. | | |
|13. | | |
|14. | | |
|15. | | |
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
NEEDS ASSESSMENT FOR STAFF
XYZ College
Date ________________
1. What percentage of your students are:
First Year ________________
Second Year _____________
Third Year _______________
Fourth Year _______________
Fifth or Higher______________
2. What percentage of your students are:
Male __________________
Female ________________
Transgender ____________
3. What is the ethnic breakdown of your student population?
|White / Caucasian: |Latino: |Black/ |Asian / Pac. |Native |Other: |
| | |African-Am.: |Islander: |American: | |
If you marked Other, please specify: ________________________________________
4. How often does your school address the following issues?
|Alcohol Use |Seldom |Sometimes |Often |
|Drug use |Seldom |Sometimes |Often |
|Unhealthy relationships |Seldom |Sometimes |Often |
|Sexual Coercion |Seldom |Sometimes |Often |
|Sexually Transmitted Diseases |Seldom |Sometimes |Often |
|Unprotected Sex |Seldom |Sometimes |Often |
|Body Image |Seldom |Sometimes |Often |
|Sexual identity and orientation |Seldom |Sometimes |Often |
5. Where do you think your students primarily obtain information about sexuality, STDs and body issues?
|Parents |Internet |Media |
|Peer health educator |Health Center |RA |
|Friends or siblings |Taught self about issues |Other |
If you marked Other, please specify: _________________________________________
6. As far as scheduling SHE, what time(s) of day and day(s) of the week do you think might work best for students?
THANK YOU FOR YOUR TIME AND VALUABLE INPUT! (
*By completing this form you agree to have the results used in the planning of this program and published and presented if they are significant.
Sexy…Healthy…Empowered!
A Sexual Health Discussion Group for College Women
SEXUAL HEALTH NEEDS ASSESSMENT FOR FEMALE STUDENTS*
XYZ College
Date ________________
1. What year are you in school?
|First |Second |Third |Fourth |Fifth or higher |
2. What is your ethnicity?
|White / Caucasian |Latino/a |Black / |Asian / Pac. |Native American |Other (please |Decline to state |
| | |African-Am. |Islander | |specify) | |
If you marked Other, please specify: _________________________________________
5. How much do you relate with the following issues?
|Alcohol Use |Not very |Somewhat |Very |
|Drug use |Not very |Somewhat |Very |
|Unhealthy relationships |Not very |Somewhat |Very |
|Sexual Coercion |Not very |Somewhat |Very |
|Sexually Transmitted Diseases |Not very |Somewhat |Very |
|Unprotected Sex |Not very |Somewhat |Very |
|Body Image |Not very |Somewhat |Very |
|Sexual identity and orientation |Not very |Somewhat |Very |
6. Who has primarily discussed information about sexuality, STDs and body issues with you?
|Parents |School teachers |Health care provider |Peer health educator |
|Friends or siblings |Taught self about issues |Never discussed issue |Other |
If you marked Other, please specify: _________________________________________
7. Would you attend a small workshop for women to learn and discuss sexuality, STDs and body issues? [Y] [N]
8. If you answered YES above in #5, what time(s) of day and day(s) of the week would work best with your schedule?
THANK YOU FOR YOUR TIME AND VALUABLE INPUT! (
*By completing this form you agree to have the results used in the planning of this program and published and presented if they are significant.
Suggested STD Risk Reduction Supplies
for Safer Sex Kits
← Safer Sex Kit Manual
← Variety of Condom Samples
← Sample Female Condom
← Sample Latex Barrier
← Dildo or Plastic Banana
o Dildos available at local sex shops and online.
o Plastic bananas available for less than a dollar at Michaels Arts and Crafts; see for locations.
← Samples of Water-Based Lubricants
← “Use/Don’t Use” Lubricant Cards
← STD Information
o Pamphlets, infocards, and hotline cards available for free download from the Los Angeles County STD Program’s Health Education Unit at .
▪ LOS ANGELES COUNTY COLLEGES ONLY: For limited hard copies, contact Sally Villanueva at savillanueva@ph..
o STD Fact Sheets available for free download from the CDC at .
← Birth Control Information
o Emergency Contraception FAQ available for free download from the US Department of Health and Human Services at .
o Birth Control Methods brochure available for free download from the Los Angeles County STD Program’s Health Education Unit at .
← STD Pictures
o LOS ANGELES COUNTY COLLEGES ONLY: Available for free on CD or via email from the Los Angeles County STD Program’s Health Education Unit. Contact Kim Harrison at kiharrison@ph..
← Sample Bleach Kit
o Cotton balls available at local drugstores.
o Syringes available online at .
o Containers and lids available online at .
SHE Brochure Resources
Materials for a charge
• ETR Associates 1-800-321-4407
• Krames 1-800-333-3032
• Channing Bete 1-800-477-4776
channing-
Free/low cost materials
• CDC National Prevention 1-800-458-5231
Information Network
• California AIDS Clearinghouse 1-888- 611-4222
• Los Angeles County STD Program 1-800-758-0880
std
SHE Literature Review Summary
STD/Sexual risks of college-age women (18-24 yrs)
Session 1
• What affects sexual decision-making and how…
o Specifically body image (good vs. poor), values/attitudes/beliefs about sex (from family, religion, culture, etc), self-esteem (high vs. low)
Body image
Eisenberg, ME, Neumark-Sztainer, D, Lust, KD, “Weight-Related Issues and High Risk Sexual Behaviors Among College Students,” Journal of American College Health. 2005 Sep-Oct;54(2):95-101.
Myles S. Faith and Mitchell L. Schare, "The role of body image in sexually avoidant behavior."
Archives of Sexual Behavior, 1993 August; 22(4):345-356.
Kearney-Cooke A, Ackard DM, "The effects of sexual abuse on body image, self-image, and sexual activity of women." J Gend Specif Med. 2000 Sep-Oct;3(6):54-60
Values/attitudes/beliefs about sex (from family, religion, culture, etc)
Poulson RL, Eppler MA, Satterwhite TN, "Alcohol consumption, strength of religious beliefs, and risky sexual behavior in college students." Journal of American College Health, 1998 Mar; 46(5):227-32
Lefkowitz ES, Gillen MM, Shearer CL, Boone TL. , “Religiosity, sexual behaviors, and sexual attitudes during emerging adulthood.” Journal of Sex Research. 2004 May;41(2):150-9
Civic D, “College students’ reasons for nonuse of condoms within dating relationships,” Journal of Sex and Marital Therapy, 2000 Jan-Mar;26(1):95-105.
Duncan C, Miller DM, Borskey EJ, "Barriers to safer sex practices among African American college students." Journal of National Medical Association. 2002 Nov;94(11):944-51
"Older adolescents' engagement in casual sex: Impact of risk perception and psychosocial motivations" Journal of Youth and Adolescence, 1995 June; 24(3): 349 - 364
Self-esteem
Sterk CE, Klein H, Elifson KW., Self-esteem and "at risk" women: determinants and relevance to sexual and HIV-related risk behaviors. Women's Health. 2004;40(4):75-92
Smith, Gabie E.; Gerrard, Meg; Gibbons, Frederick X. "Self-esteem and the relation between risk behavior and perceptions of vulnerability to unplanned pregnancy in college women"
Health Psychology. 1997 Mar Vol 16(2) 137-146
Salazar LF, DiClemente RJ, Wingood GM, "Self-concept and adolescents' refusal of unprotected sex: a test of mediating mechanisms among African American girls."
Prev Sci. 2004 Sep;5(3):137-49.
Gardner LH, Frank D, Amankwaa LI. "A comparison of sexual behavior and self-esteem in young adult females with positive and negative tests for sexually transmitted diseases."
ABNF J. 1998 Jul-Aug;9(4):89-94.
The University of Texas at Austin, Counseling and Mental Health Center. “Better Self-Esteem.” utexas.edu, 1999.
Definitions of body image, values/attitudes, and self-esteem
Body Image- The way a person thinks about his or her body and how it looks to others.
Values- Values are principles that guide our behavior. They are deep-seated psychological constructs that form the foundation of our goal-seeking behavior.
Attitudes- Attitudes express values, evaluate or show feeling about some idea, person, object, event, situation, or relationship.
Self-esteem- Pride in oneself; self-respect.
------------------------------------------------------------------------------------------
Session 2
Importance of practicing safer sex skills (how to use a condom, female condom, etc)
o Self-efficacy
Baker, SA; Beadnell, B., "Skills training versus health education to prevent STDs/HIV in heterosexual women: a randomized controlled trial utilizing biological outcomes.
AIDS Education and Prevention. 2003 Feb;15(1):1-14.
Fisher, J.D. and Fisher, W. A. , “Changing AIDS Risk Behavior,” Psychological Bulletin, 111:455-474, 1992
Rotheram-Borus, M.J., Maheler, K.A. and Rosario, M., “AIDS Prevention with Adolescents,” AIDS Education and Prevention, 7:320-336, 1995.
Brien TM, Thombs DL, Mahoney CA, Wallnau L, “Dimensions of self-efficacy among three distinct groups of condom users,” Journal of American College Health. 1994 Jan;42(4):167-74.
Importance of negotiating safer sex skills
O’Leary A, Goodhart F, Jemmott LS, Boccher-Lattimore D., “Predictors of safer sex on the college campus: a social cognitive theory analysis,” Journal of American College Health, 1992 May;40(6):254-63.
Efficacy of small group, informal discussion, rap session to teach STD info/skills
Shain, RN; Piper,JM; Newton, ER, "A randomized, controlled trial of a behavioral intervention to prevent sexually transmitted disease among minority women."
New England Journal of Medicine. 1993 Jan 14;340(2):93-100.
Basen-Engquist, K, "Evaluation of a theory-based HIV prevention intervention for college students." AIDS Education and Prevention.1994 Oct;6(5):412-24
Card, J., Niego, S., Mallari, A., Farrell, W.S., “The Program Archive on Sexuality, Health & Adolescence: Promising 'Prevention Programs in a Box," Family Planning Perspectives, 1996 Sept-Oct;28(5):210-220
-----------------------
STDs
Safer Sex
Body Image
Values
Birth Control
Self-Esteem
Relationships
................
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